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HomeMy WebLinkAbout2016-409-E DSS - Holcomb and Cabe for legal services DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 Contract#68-2001 Flolcomb and Cabe, L.L.P. Contract 68'2O01.____ Fiscal Year Be 'om Julyl,_20]6DImdm June 30'2Ol7 __ This contract is hozebv entered into by and between the Orange County Department of Social Services (the "County") and Holcomb and Cabe, 'L.L.P. (the "Contractor") (referred to collectively as the "Parties"). The Contractor's federal tax identification number or Social Security Number is _ Contract Documents: This Contract consists of the following documents (1) This contract (2) The General Tcmaoand Condiduos (/\�uoboocnt/�) (3) The Scope of\�nck, desohpdonof services, and rut (Attachment B) `4/ Federal Ce��iOca1ionRegarding Drug-Free YYorkp|ace8c Certification E<cgardimg��uudiscrhninm(iun(/��uoboeutC) `5' Cunflic1ofInterest(Attachment D) ` ' (6) No Overdue Taxes (Attachment F) (7) Federal Certification Regarding Lobbying (Attachment G) (8) Federal Certification Regarding Debarment (Attachment H) (9) State Certifications(Attachment M) (10) Outcomes and Reporting(Attachment N) (lI)Contract Determination Questionnaire These documents constitute the entire agreement between the Parties and supersede all prior oral or written stat ments or agreements. 1. Precedence Among Contract Documents: In the event of a conflict between or among the terms of the Contract Documents, the terms in the Contract Document vviththe highest relative precedence shall prevail. The order of precedence shall be the or o[dncumeo�a as listed in Paragraph 1, above, with the first-listed document having the highest precedence and the last-listed document having the lowest precedence. If there are multiple Contract d ^—zts, the most recent amendment shall have the highest precedence and the oldest amendment shall have the lowest precedence. 2. Effective Period: This contract shall be effective on July 1,2016 and shall terminate on June 30,2017.The contract may automatically be extended for two additional one year terms under the same terms of this Agreement unless one of the Parties provides the other with notice of intent to terminate or amend no later than 60 days prior to the end of the contract term. This contract must be twelve months or less. 3. Contractor's Duties: The Contractor shall provide the services and in accordance with the approved rate as described in Attachment B, Scope of Work, and shall meet the requirements set forth in Attachment N, Outcomes and Reporting. 4. County's Duties: The County shall pay the Contractor in the manner and in the amounts specified in the Contract Documents. The total amount paid hv the County to the Con{n�torunder this contract shall not exceed $165,800. This amount consists of$165,000 in Federal (CFDA # ), State and County funds, $0 (source ofn/har funds if applicable). [X] a. There are no matching requirements from the Contractor. [ ] b. The Contractor's matching requirement is $ , which shall consist of [ ] Io-kind [ ] Cash [ ] Cash and In-kind [ ] Cash aod/orlo-kiud The contributions from the Contractor shall be sourced from non-federal funds. The total contract amount including any Contractor match shall not exceed $165,000. 5. Reversion of Funds: Any unexpended grant funds shall revert to the County Department of Social Services upon termination of this contract. Contract-General(06/15) Page 1 of 5 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 ! ' Contract 468-2001 Holcomb and Cabe, LLP. 6. Reporting Requirements: Contractor shall comply with audit requirements as described in N.C.G.S. § 143['6'22 & 23 and OMB Circular—CFR Title 2 Grants and Agreements, Part 200, and shall disclose all information required by 42 USC 455.104, or 42 USC 455.l85, or42 USC 455.]U6. 7. Payment Provisions: Payment shall be made in accordance with the Contract Documents as described in the Scope of Work, Attachment B. 8. Contract Administrators: All notices permitted or required to be given by one Party to the other and all questions abot t the contract from one Party to the other shall be addressed and delivered to the other Party's Contract Administrator. Thc name,post office address,street address,telephone number,fax number,and email address of the Parties'respective initia 1 Contract Administrators are set out below. Either Party may change the name, post office address, street address, telephone number,fax number,or email address of its Contract Administrator by giving timely written notice to the other Party. 9. Key Personnel: Carol Holcomb is the Key Personnel assigned to the performance of this contract. Ms. Holcomb must perform at least 80 percent of all services described in the Scope of Work, Attachment B. For the County: lF DELIVERED DyUS90Sl�LSERVICE IF DELIVERED BY ANY OTHER yNpAN3 Denise Shaffer, Social Work P gaon Director Denise Shaffer, Social Work Program Director Orange County Department of Social Services Orange County Department of Social Services P.O. Box 8181 2501 Homestead Road Hillsborough, NC27278 Chapel Hill, NC 27516 (919) 245-2246 dobuOferk��.orungc.oc.us For the Contractor: IF DELIVERED BY0S90B��L ��R��� RD��{�8RE�8�A�\/OTNEB/�[. T�� | ° Carol Holcomb Carol Holcomb Holcomb and Cabe, L.L.P. Holcomb and L.L.P. � Cabe, . . . 2013 S. Lakeshore Drive 2013 S. Lakeshore Drive Chapel Hill,NC 27514 Chapel Hill, NC 27514 i J Contract-General (06/15) Page 2 of 5 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 Comtract#68'20Ol Holcomb and Cabe, L.L,P. 18, No Assignment or Sub-Contract: Contractor shall not sub-contract out any of the services provided for in this Agreement or make any assignment of this Agreement(including rights to payments)without the prior written Consent of the County as specified more fully in Attachment A, General Terms and Conditions. 11 Supplementation '[he[oo�mo<orassures that funds received pursuant to this contract ` shall be used only to supplement, not to supplant, the total amount of federal, state and local public funds that the Contractor otherwise expends for contract services and related programs.Funds received under this contract shall be used to provide additional public funding for such services; the funds shall not be used to reduce the Contractor's total expenditure of other public funds for such services. 12. Disbursements: As a condition of this contract, the Contractor acknowledges and agrees to make disbursements in accordance with the following requirements: a. Implement adequate internal controls over disbursements; b. Pre-audit all vouchers presented for payment to determine: i. Validity and accuracy of payment ii. Payment due date iii. Adequacy of documentation supporting payment iv. Legality of disbursement c. Assure adequate control of signature stamps/plates; J. Assure adequate control of negotiable instruments; and e. Implement procedures to insure that account balance is solvent and reconcile the account monthly. 13. Outsourcing to Other Countries: The Contractor certifies that it has identified to the County all jobs related to the contract that have been outsourced to other countries, if any.The Contractor further agrees that it will not outsource any such jobs during the term of this contract without providing notice to the County. 14. Federal Certifications: Individuals and Organizations receiving federal funds must ensure compliance with certain certifications required by federal laws and regulations. The contractor is hereby complying with Certifications regarding Nondiscrimination, Drug-Free Workplace Requirements, Environmental Tobacco Smoke, Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Tier Covered Transactions, and Lobbying. These assurances and certifications are to be signed by the contractor's authorized representative. 15. Relationship of the Parties: Contractor is an independent contractor of the County. Contractor represents that it has or will secure,at its own expense,all personnel required in performing the services under this Agreement. Such personnel shall not be employees of or have any contractual relationship with the County. All personnel engaged in work under this Agreement shall be fully quulificdand shall be authorized n«permitted under state and local law to perform such services. It is further agreed by Contractor that it shall obey all State and Federal statutes,rules and regulations which are applicable to provisions of the services called for herein. Neither Contractor nor any'employee of the Contractor shall be deemed an officer, employee or agent of the County. 16. Signature Warranty: The undersigned represent and warrant that they are authorized to bind their principals to the terms of this agreement. The Contractor and the County have executed this contract in duplicate originals,with one original being retained by each party. This Agreement together with any'amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the intent of the Parties to comply with Article 1 l A and Article 40 of North Carolina General Statute Chapter 66. [SIGNATURE PAGE TO FOLLOW] Contract-General (06/15) Page 3 of 5 ■!I■ DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 Contract 468-2001 liolcomb and Cabe, L.L.P. HOLCOM Osett E, L.L.P. (Ant ROtavvIli 7/18/2016 _alCIFE3117A1LCJAGI Signature Date Carol Holcomb Attorney Printed Name Title ORANGE CO,UNcVsgNOTH CAROLINA A-cuAiwIt-Y'SttAi 13y: 7/29/2016 06,3743841375,5E4 Bonnie Hammers ley, County Manager Date Contract-General(06/15) Page 4 015 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 ATTACHMENT A GENERAL TERMS AND CONDITIONS Orange County Department of Social Services Relationships of the Parties the County or the Contractor,receiving services or benefits under this contract shall be deemed an incidental Independent Contractor: The Contractor is and shall be beneficiary' only. deemed to be an independent contractor in the performance of this contract and as such shall be wholly responsible for Indemnity and Insurance the work to he performed and for the supervision of its employees. The Contractor represents that it has, or shall Indemnification: The Contractor agrees to indemnify and secure at its own expense, all personnel required in hold harmless the County and any of their officers, agents performing the services under this agreement. Such and employees, from any claims of third parties arising out employees shall not be employees of, or have any or any act or omission of the Contractor in connection with individual contractual relationship with the County. the performance of this contract. Subcontracting: The Contractor shall not subcontract any Insurance: During the term of the contract,the Contractor of the work contemplated under this contract without prior at its sole cost and expense shall provide commercial written approval from the County. Any approved insurance of such type and with such terms and limits as subcontract shall be subject to all conditions of this may be reasonably associated with the contract. As a contract. Only the subcontractors specified in the contract minimum, the Contractor shall provide and maintain the documents are to be considered approved upon award of following coverage and limits: the contract. The County shall not be obligated to pay for (a) Worker's Compensation - The contractor shall any work performed by any unapproved subcontractor. provide and maintain Worker's Compensation The Contractor shall be responsible for the performance of Insurance as required by the laws of North all of its subcontractors. Carolina,as well as employer's liability coverage with minimum limits of$500,000.00,covering all Assignment: No assignment of the Contractor's of Contractor's employees who are engaged in any obligations or the Contractor's right to receive payment work under the contract. if any work is sublet,the hereunder shall be permitted. However, upon written Contractor shall require the subcontractor to request approved by the issuing purchasing authority, the provide the same coverage for any of his County may: employees engaged in any work under the (a) Forward the Contractor's payment check(s) contract. directly to any person or entity designated by the (b) Commercial General Liability - General Contractor, or Liability Coverage on a Comprehensive Broad (b) Include any person or entity designated by Form on an occurrence basis in the minimum Contractor as a joint payee on the Contractor's amount of$1,000,000.00 Combined Single Limit. payment check(s). (Defense cost shall be in excess of the limit of In no event shall such approval and action obligate the liability.) County to anyone other than the Contractor and the (c)Automobile Liability Insurance: The Contractor Contractor shall remain responsible for fulfillment of all shall provide automobile liability insurance with a contract obligations, combined single limit of$500,000.00 for bodily injury and property damage; a limit of Beneficiaries: Except as herein specifically provided $500,000.00 for uninsured/under insured motorist otherwise,this contract shall inure to the benefit of and be coverage; and a limit of$25,000.00 for medical binding upon the parties hereto and their respective payment coverage. The Contractor shall provide successors. It is expressly understood and agreed that the this insurance for all automobiles that are: enforcement of the terms and conditions of this contract, (a) owned by the Contractor and used in the and all rights of action relating to such enforcement, shall performance of this contract; be strictly reserved to the County and the named (b) hired by the Contractor and used in the Contractor.Nothing contained in this document shall give performance of this contract; and or allow any claim or right of action whatsoever by any (c) Owned by Contractor's employees and other third person. It is the express intention of the County used in performance of this contract("non- and Contractor that any such person or entity, other than owned vehicle insurance"). Non-owned General Terms and Conditions—(06/16) Page 1 of 5 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 vehicle insurance protects employers when employees use their personal vehicles for Termination Without Cause: The County may termina work purposes. Non-owned vehicle this contract without cause by giving 30 days writte insurance supplements, but does not notice to the Contractor. replace,the car-owner's liability insurance. Termination for Cause: lf, through any cause, th The Contractor is not required to provide and maintain Contractor shall fail to fulfill its obligations under thi. automobile liability insurance on any vehicle----owned, contract in a timely and proper manner, the County shal hired, or non-owned -- unless the vehicle is used in the have the right to terminate this contract by giving writte performance of this contract. notice to the Contractor and specifying the effective dat (d) The insurance coverage minimums specified in thereof. In that event,all finished or unfinished deliverabl subparagraph(a) are exclusive of defense costs. items prepared by the Contractor under this contract shal , (e) The Contractor understands and agrees that the at the option of the County, become its property and th- insurance coverage minimums specified in Contractor shall be entitled to receive just and equitabl subparagraph (a) are not limits, or caps, on the compensation for any satisfactory work completed on sue Contractor's liability or obligations under this contract. materials,minus any payment or compensation previousl, (f) The Contractor may obtain a waiver of any one or more made. Notwithstanding the foregoing provision, th of the requirements in subparagraph (a) by Contractor shall not be relieved of liability to the Coun' demonstrating that it has insurance that provides for damages sustained by the County by virtue of th protection that is equal to or greater than the coverage Contractor's breach of this agreement,and the County ma, and limits specified in subparagraph (a). The County withhold any payment due the Contractor for the purpos- shall be the sole judge of whether such a waiver of setoff until such time as the exact amount of damage. should be granted. due the County from such breach can be determined. I (g) The Contractor may obtain a waiver of any one or more case of default by the Contractor, without limiting an, of the requirements in paragraph(a)by demonstrating other remedies for breach available to it,the County ma that it is self-insured and that its self-insurance procure the contract services from other sources and hol provides protection that is equal to or greater than the the Contractor responsible for any excess cost occasione, coverage and limits specified in subparagraph(a). The thereby. The filing of a petition for bankruptcy by th County shall be the sole judge of whether such a Contractor shall be an act of default under this contract. waiver should be granted. (h) Providing and maintaining the types and amounts of Waiver of Default: Waiver by the County of any defau0 insurance or self-insurance specified in this paragraph or breach in compliance with the terms of this contract b is a material obligation of the Contractor and is of the the Provider shall not be deemed a waiver of an essence of this contract. subsequent default or breach and shall not be construed t+ (i) The Contractor shall only obtain insurance from be modification of the terms of this contract unless state, companies that are authorized to provide such to be such in writing, signed by an authorize+ coverage and that are authorized by the Commissioner representative of the County and the Contractor mil of Insurance to do business in the State of North attached to the contract. Carolina.All such insurance shall meet all laws of the State of North Carolina. Availability of Funds: The parties to this contract agre, (j) The Contractor shall comply at all times with all lawful and understand that the payment of the sums specified i terms and conditions of its insurance policies and all this contract is dependent and contingent upon and subjec lawful requirements of its insurer, to the appropriation, allocation, and availability of fund. (k) The Contractor shall require its subcontractors to for this purpose to the County. comply with the requirements of this paragraph. (1) The Contractor shall demonstrate its compliance with Force Majeure: Neither party shall be deemed to be Ii the requirements of this paragraph by submitting default of its obligations hereunder if and so long as it certificates of insurance to the County before the prevented from performing such obligations by any act o Contractor begins work under this contract. war,hostile foreign action,nuclear explosion,riot,strike , civil insurrection,earthquake, hurricane,tornado,or othe Transportation of Clients by Contractor: catastrophic natural event or act of God. The contractor will maintain Insurance requirements if required as noted under Article 7 Rule R2-36 of the North Survival of Promises: All promises,requirements,term.:, Carolina Utilities Commission. conditions, provisions, representations, guarantees, and warranties contained herein shall survive the contra Default and Termination expiration or termination date unless specifically provideo General Terms and Conditions--(06/16) Page 2 of DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 otherwise herein, or unless superseded by applicable that comply with all applicable federal, state and Federal or State statutes of limitation, local laws,regulations, and rules. Intellectual Property Rights (b) Duty to Report: The Contractor shall report a suspected or confirmed security breach to the Copyrights and Ownership of Deliverables: All local Department of Social Services Contract deliverable items produced pursuant to this contract are the Administrator within twenty-four(24)hours exclusive property of the County. The Contractor shall not after the breach is first discovered, provided that assert a claim of copyright or other property interest in the Contractor shall report a breach involving such deliverables. Social Security Administration data or Internal Revenue Service Data within one(1) hour after Federal Intellectual Property Bankruptcy Protection the breach is first discovered. Act: The Parties agree that the County shall be entitled to all rights and benefits of the Federal Intellectual Property (c) Cost Borne by Contractor: If any applicable Bankruptcy Protection Act,Public Law 100-506,codified federal, state, or local law, regulation or rule at 11 U.S.C. 365 (n) and any amendments thereto. requires the Contractor give written notice of a security breach to affected persons, the Contract Compliance with Applicable Laws, shall bear the cost of the notice. Compliance with Laws: The Contractor shall comply Trafficking Victims Protection Act of 2000: with all laws, ordinances, codes, rules, regulations, and The Contractor will comply with the requirements of licensing requirements that are applicable to the conduct of Section 106(g)of the Trafficking Victims Protection Act its business, including those of federal, state, and local of 2000, as amended (22 U.S.C. 7104) agencies having jurisdiction and/or authority. By executing this Agreement Provider certifies that Executive Order#24: It is unlawful for any vendor, Provider has not been identified, and has not utilized contractor, subcontractor or supplier of the state to make the services of any agent or subcontractor, on the list gifts or to give favors to any state employee. For created by the State Treasurer pursuant to G.S. 147- additional information regarding the specific requirements and exemptions, contractors are 86.58. encouraged to review Executive Order 24 and G.S. Sec. 133-32. Title VI, Civil Rights Compliance: In accordance with Federal law and U.S. Department of Agriculture(USDA) Confidentiality and U.S. Department of Health and Human Services (fillS) policy, this institution is prohibited from Confidentiality: Any information, data, instruments, discriminating on the basis of race, color, national origin, documents, studies or reports given to or prepared or sex, age or disability. Under the Food Stamp Act and assembled by the Contractor under this agreement shall be USDA policy, discrimination is prohibited also on the kept as confidential and not divulged or made available to basis of religion or political beliefs. any individual or organization without the prior written approval of the County.The Contractor acknowledges that Equal Employment Opportunity: The Contractor shall in receiving,storing,processing or otherwise dealing with comply with all federal and State laws relating to equal any confidential information it will safeguard and not employment opportunity. further disclose the information except as otherwise provided in this contract. Health Insurance Portability and Accountability Act (IIIPAA): The Contractor agrees that, if the County determines that some or all of the activities within the scope of this contract are subject to the Health insurance Oversight Portability and Accountability Act of 1996, P.L. 104-91, as amended ("H1PAA"), or its implementing regulations, Access to Persons and Records: The State Auditor shall it will comply with the HIPAA requirements and will have access to persons and records as a result of all execute such agreements and practices as the County contracts or grants entered into by State agencies or may require to ensure compliance. political subdivisions in accordance with General Statute 147-64.7. Additionally,as the State funding authority,the (a) Data Security: The Contractor shall adopt and Department of Health and I luman Services shall have apply data security standards and procedures access to persons and records as a result of all contracts or General Terms and Conditions—(06/16) Page 3 of 5 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 grants entered into by State agencies or political below,and the Contractor's subcontractors,complies wit subdivisions. the requirements of Article 2 of Chapter 64 of the N General Statutes. Record Retention: Records shall not be destroyed,purged or disposed of without the express written consent of the Miscellaneous Division. State basic records retention policy requires all grant records to be retained for a minimum of five years or Choice of Law: The validity'of th is contract and any of it until all audit exceptions have been resolved,whichever is temis or provisions, as well as the rights and duties of th longer. If the contract is subject to federal policy and parties to this contract, are governed by the laws of Nortn regulations,record retention may be longer than five years Carolina. The Contractor, by signing this contract, agree. since records must be retained for a period of three years and submits,solely for matters concerning this Contract,t■ following submission of the final Federal Financial Status the exclusive jurisdiction of the courts of North Carotin, Report, if applicable, or three years following the and agrees, solely for such purpose, that the exclusiv, submission of a revised final Federal Financial Status venue for any legal proceedings shall be Orange Count , Report. Also, if any litigation, claim, negotiation, audit, North Carolina. The place of this contract and all disallowance action,or other action involving this Contract transactions and agreements relating to it, and their situ. has been started before expiration of the five-year retention and forum,shall be Orange County,North Carolina,wher period described above,the records must be retained until all matters,whether sounding in contract or tort,relating ti completion of the action and resolution of all issues which the validity,construction, interpretation,and enforceme arise from it,or until the end of the regular five-year period shall be determined. described above, whichever is later. The record retention period for Temporary Assistance for Needy Families Amendment: This contract may not be amended orally o (TAN F) and MEDICAID and Medical Assistance grants by performance. Any amendment must be made in wittel and programs must be retained for a minimum often years. form and executed by duly authorized representatives of the County and the Contractor. Warranties and Certifications Severability: In the event that a court of competen Date and Time Warranty: The Contractor warrants that jurisdiction holds that a provision or requirement of thi. the product(s) and service(s) furnished pursuant to this contract violates any applicable law, each such provisiofl contract("product"includes,without limitation,any piece or requirement shall continue to be enforced to the extent of equipment,hardware,firmware,in iddleware,custom or is not in violation of law or is not otherwise unenforceabl commercial software,or internal components,subroutines, and all other provisions and requirements of this contra. and interfaces therein) that perform any date and/or time shall remain in full force and etTect, data recognition function, calculation, or sequencing will support a four digit year format and will provide accurate Headings: The Section and Paragraph headings in thes,' date/time data and leap year calculations. This warranty General Terms and Conditions are not material parts of th' shall survive the termination or expiration of this contract. agreement and should not be used to construe the mean in;:. thereof. Certification Regarding Collection of Taxes: G.S. 143- 59.1 bars the Secretary of Administration from entering Time of the Essence: Time is of the essence in fin,. into contracts with vendors that meet one ofthe conditions performance of this contract. of G.S. 105-164.8(b)and yet refuse to collect use taxes on sales of tangible personal property to purchasers in North Key Personnel: The Contractor shall not replace any of Carolina. The conditions include: (a) maintenance of a the key personnel assigned to the performance of thi. retail establishment or office; (b) presence of contract without the prior written approval of the Count . representatives in the State that solicit sales or transact The term "key personnel" includes any and all person business on behalf of the vendor; and (c) systematic identified as such in the contract documents and any othe exploitation of the market by media-assisted, media- persons tibsequently identified as key personnel by th facilitated, or media-solicited means. The Contractor written agreement of the parties. certifies that it and all of its affiliates (if any) collect all required taxes. Care of Property: The Contractor agrees that it shall bo responsible for the proper custody and care of any propert E-Verify furnished to it for use in connection with the performanc, of this contract and will reimburse the County for loss o , Pursuant to G.S. 143-48.5 and G.S. 147-33.95(g), the or damage to, such property. At the termination of thi; undersigned hereby certifies that the Contractor named contract, the Contractor shall contact the County fo General Terms and Conditions—(06/16) Page 4 of DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 instructions as to the disposition of such property and shall comply with these instructions. Orange County Living Wage: Orange County is committed to providing its employees with a living wage Travel Expenses: Reimbursement, if provided in this and encourages agencies to which it provides funding to Agreement, to the Contractor for travel mileage, meals, pursue the same goal. The County's living wage hourly lodging and other travel expenses incurred in the standard, as adopted by the Orange County Board of performance of this contract shall not exceed the rates County Commissioners annually, can be found in the established in County policy. Orange County Budget Ordinance. To the extent possible, Orange County recommends that the Contractor and all Sales/Use Tax Refunds: If eligible,the Contractor and all subcontractors provide a living wage, as defined in this subcontractors shall: (a) ask the North Carolina section, to their employees. Department of Revenue for a refund of all sales and use taxes paid by them in the performance of this contract, Signatures: This Agreement together with any pursuant to G.S. 105-164.14; and (b) exclude all amendments or modifications may be executed refundable sales and use taxes from all reportable electronically. All electronic signatures affixed hereto expenditures before the expenses are entered in their evidence the intent of the Parties to comply with Article reimbursement reports. 11 A and Article 40 of North Carolina General Statute Chapter 66. Advertising: The Contractor shall not use the award of this contract as a part of any news release or commercial advertising. General Terms and Conditions--(06/16) Page 5 of 5 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 ATTACHMENT B SCOPE OF WORK Orange County Department of Social Services Fedcrat Tax Id. or SSN Coutmuuk# 68'2001 A. CONTRACTOR INFORMATION l. Contractor Agency Name: llo|conoh and Cabe, [.I_P. Z. /fJiffe,cx/from Contract Administrator Information in General Contract: Address __ Telephone Number: _ Fax Number: Rmail: ____ 3. Name of Program (s): l.c~ul Services 4. Status: ( ) Public ( ) Private,Not for Profit (X)Private, For Profit 5. Contractors Financial Reporting Year July 2016 through June 30, 2017 B. Explanation of Services to be provided and to whom (include SIS Service Code): The Contractor will provide legal consultation to agency staff regarding child welfare issues and adult protective services cases. The Contractor will conduct court proceedings arid handle other legal matters on behalf of the County related to adoption, foster care, adult protective services and child protective services. Tbc Contractor required Jo meet all goals and outcomes listed in Attachment N. C. Rate per unit of Service(define the unit): 1. If Standard Fixed Rate, Maximum Allowable, (See Rates for Services Chart) 2.Negotiated County Rate. __$165/hour_________ D.Number of units \ohuprovided:_ __ E. Dctui|aofBillimgprocesoaudIirocFruozee; ThcCougt/v/i||reimbyLsedle Contractor for services described in this co udgetary limits of the cont nr reimbursement the Contractor must submit an orig o copies of an invoice by the fifth of the month for the precedinmonth's expenditures to the designated County Administrator. The County will oroo the Contractor monthly upon receipt and correctly filed report. The Contractor shall be compensated at the hourly rate set forth in this contr oudance at programs, meetings and seminars relating to Social Services law, and for any training provided to Contract-Scope of Work (07/08) Page lofl DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 the Department's em to ees and shall be reimbursed for lodging and transportation necessary for attendance at those pro2ra.ms meetin YS seminars and resentatiorts, The Contractor shall be reimbursed for the services of clerks and legal assistants hired to assist the Contractor in the performance of the Contractor's duties to the County, and the cost of faxin_g, telephone copying, and postal expenses at a flat rate of $500.00/month. Related costs and expenses advanced by the Contractor on behalf of the County shall be reimbursed to Contractor. The Contractor shall be reimbursed for the services of expert witnesses hired to assist the Contractor in the ilerformance of the Contractor's duties to the County. F. Area to be served/Delivery site(s): Orange County EiDocuSigned by: ,DoocouLSigtknedo by: 14; tUAtil CoSIVA, DAE-1-E-1-96,4838455. E1347-.41_7-C.74C (Signature of County Authorized Person) (Signature of Contractor) 7/19/2016 7/18/2016 (Date Submitted) (Date Submitted) Contract-Scope of Work(07/08) Pave 2of 2 onnunignsnvoopo0�o�n�or�o��soo�oo4*m�*�n�oe�on�ocrn Envelope ID: ATTACHMENT C CERTIFICATION REGARDING DRUG-FREE WORKPLACE REQUIREMENTS AND CERTIFICATION REGAR[)ING NONDISCRIMINATION Orange County Department of Social Services I. By execution of this Agreement the Contractor certifies that it will provide a drug-free workplace by: A. Publishing a statement notizing employees that the unlawful manufacture, distribution, dispensing, possession or use of a controlled substance is prohibited in the Contractor's workplace and specifying the actions that will be taken against employees for violation of such bih � yro hz oo�, D. Establishing a d awareness program to inform employees about: (I) The dangers of drug abuse in the workplace (2)The Contracto 's policy of maintaining a drug-free workplace; (3) Any available drug counseling, rehabilitation, and employee assistance programs; and (4)The penalties that may be imposed upon employees for drug abuse violations occurring in the workplace; C. Making it a requirement that each employee he engaged in the performance of the agreement be given a copy of the statement required by' paragraph (A); D. Notifying the employee in the statement required by paragraph (A)that, as a condition of employment under the agreement, the employee will: (I)Abide by the terms of the statement; and (2)Noti 'the employer of any criminal dnig statute conviction for a violation occurring in the workplace no later than five days after such conviction; E. Notifying the County within ten days after receiving notice under subparagraph (U)(2) from an employee or otherwise receiving actual notice of such conviction; F. Taking one of the following actions,within 30 days of receiving notice under subparagraph (D)(2), with respect to any employee who is so convicted: (1) Taking appropriate personnel action against such an employee, up to and including termination; or (2) Requiring such employee to participate satisfactorily' in a drug abuse assistance or rehabilitation program approved for such purposes by a Federal, State, or local health, law enforcement, or other appropriate agency'; and Making a good faith effort to continue to maintain a drug-free workplace through implementation of paragraphs (A), (B), (C), (D), (E), and (F). Federal Certification- Drug-Free Workplace (07/10) Page 1 of DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 II. The site(s) for the performance of work done in connection with the specific agreement are listed below: l. (Street (City, county, state, zip code) — (Street address) (City, county, state, zip code) Contractor will inform the County of any additional sites for performance of work under this agreement. False certification or violation of the certification shall bc grounds for suspension of payment, suspension or termination of grants, or government-wide Federal suspension or debarment(45 C,F.R. Section 82.510. Section 4 CFR Part 85, Section 85.615 and 86.620). CERTIFECATION REGARDING NONDISCRIMINATION The Vendor certifies that it will comply with all Federal statutes relating to nondiscrimination. These include but are not limited to: (a)Title VI of the Civil Rights Act of 1964 (9l. 88'352) which prohibits discrimination on the basis of race, color or national origin; (b) Title IX of the Education Amendments of ]q72, os amended (20U.S.C. O§}68l 1683, and 1685-1686), which prohibits discrimination on the basis of sex; (c) Section 504 of the Rehabilitation Act of 1973, as amended (29 U.S.C. §794), which prohibits discrimination on the basis of handicaps; (d)the Age Discrimination Act of 1975, as amended (42 U.S.C. §§6101-6107), which prohibits discrimination on the basis of age; (e) the Drug Abuse Office and Treatment Act e[}97Z (P.L. 92'255), au amended, relating to nondiscrimination on the basis of drug abuse; (0 the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation 1 Act ofl970 (P.L. 9l'6l6), am amended, relating to nondiscrimination on the basis of alcohol abuse or alcoholism; (g) Title VIII of the Civil Rights Act of 1968 (42 U.S.C. §G3601 et seq.), as amended, relating to nondiscrimination in the sale, rental or financi of housing; (h)the Food Stamp Act and USDA policy, which prohibit discrimination on the basis of religion and political beliefs; and (i)the requirements of any other nondiscrimination statutes which may apply to this Agreement. DocuSigned w « ' Cool, RotaKiti Attorney Signature Title Holcomb & Cabe, LLP' 7/I8/2016 _ __ _ . Agency/Organization Date (Certification signature should be same as Contract signature.) • Federal Certification Drug-Free Workplace(07/10) Page 2 of 2 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 ATTACHMENT D CONFLICT OF INTEREST POLICY Orange County Department of Social Services The Board of Directorsifrustees or other governing persons, officers, employees or agents are to avoid any conflict of interest, even the appearance of a conflict of interest. The Organization's Board of Directors/Trustees or other governing body, officers, staff and agents are obligated to always act in the best interest of the organization.This obligation requires that any Board member or other governing person,officer, employee or agent, in the performance of Organization duties, seek only the furtherance of the Organization mission. At all times, Board members or other governing persons, officers, employees or agents, are prohibited from using their job title, the Organization's name or property, for private profit or benefit A. The Board members or other governing persons, officers, employees, or agents of the Organization should neither solicit nor accept gratuities, favors, or anything of monetary value from current or potential contractors/vendors, persons receiving benefits from the Organization or persons who may benefit from the actions of any Board member or other governing person, officer, employee or agent. This is not intended to preclude bona-fide Organization fund raising- activities. B. A Board or other governing body member may,with the approval of Board or other governing body, receive honoraria for lectures and other such activities while not acting in any official capacity for the Organization. Officers may, with the approval of the Board or other governing body, receive honoraria for lectures and other such activities while on personal days, compensatory time, annual leave, or leave without pay. Employees may, with the prior written approval of their supervisor, receive honoraria for lectures and other such activities while on personal days, compensatory time, annual leave, or leave without pay. If a Board or other governing body member, officer, employee or agent is acting in any official capacity, honoraria received in connection with activities relating to the Organization are to be paid to the Organization. C.No Board member or other governing person, officer, employee,or agent of the Organization shall participate in the selection, award,or administration of a purchase or contract with a vendor where,to his knowledge,any of the following has a financial interest in that purchase or contract: 1. The Board member or other governing person,officer,employee,or agent; 2. Any member of their family by whole or half blood, step or personal relationship or relative-in-law; 3. An organization in which any of the above is an officer,director, or employee; 4. A person or organization with whom any of the above individuals is negotiating or has any arrangement concerning prospective employment or contracts. D. Duty to Disclosure--Any conflict of interest, potential conflict of interest, or the appearance of a conflict of interest is to be reported to the Board or other governing body or one's supervisor immediately. E.Board Action— When a conflict of interest is relevant to a matter requiring action by the Board of Directors/Trustees or other governing body,the Board member or other governing person,officer,employee, or agent(person(s))must disclose the existence of the conflict of interest and be given the opportunity to disclose all material facts to the Board and members of Conflict of Interest Policy(06/04) Page 1 of 3 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 NOTARIZED CONFLICT OF INTEREST POLICY State of North Carolina County of Orange Ina,rP A. i4,rd , Notary Public for said County and State, certify that (am/ 1461c, rilio personally appeared before me this day and acknowledged that be/she is A Pcw4v,er of ctp and by that authority duly given and as the act of the corporation, affirmed that the foregoing Conflict of Interest Policy was adopted by the Board of Directors in a meeting held on the day of Sworn to and subscribed before me this k hi& day of a.t.itt ,Z0/4 Yncr4i, - MARTHA H FORD NOTARY PUBLIC (Official Seal) WAKE COUNTY,NC Notary Public My Cannession Expires 2.26-20/i_ My Commission expires 0.2jZ ,20/ 7/ Conflict of Interest Policy(06/04) Page 3 of 3 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 committees with governing board delegated powers considering the possible conflict of interest. After disclosure of all material facts,and after any discussion with the person,he/she shall leave the governing board or committee meeting while the determination of a conflict of interest is discussed and voted upon. The remaining board or committee members shall decide if a conflict of interest exists. In addition,the person(s) shall not participate in the final deliberation or decision regarding the matter under consideration and shall leave the meeting during the discussion of and vote of the Board of Directors/Trustees or other governing body. F. Violations of the Conflicts of Interest Policy — If the Board of Directors/Trustees or other governing body has reasonable cause to believe a member, officer, employee or agent has failed to disclose actual or possible conflicts of interest, it shall inform the person of the basis for such belief and afford the person an opportunity to explain the alleged failure to disclose. If, after hearing the person's response and after making further investigation as warranted by the circumstances, the Board of Directors/Trustees or other governing body determines the member, officer, employee or agent has failed to disclose an actual or possible conflict of interest, it shall take appropriate disciplinary and corrective action. G. Record of Conflict — The minutes of the governing board and all committees with board delegated powers shall contain: 1. The names of the persons who disclosed or otherwise were found to have an actual or possible conflict of interest, the nature of the conflict of interest, any action taken to determine whether a conflict of interest was present, and the governing board's or committee's decision as to whether a conflict of interest in fact existed. 2. The names of the persons who were present for discussions and votes relating to the transaction or arrangement that presents a possible conflict of interest, the content of the discussion, including any alternatives to the transaction or arrangement, and a record of any votes taken in connection with the proceedings. Approved by: i ht.eirwb i G•iae, LGP Name of Organization / 1. Signat e( 1 f Organization Official (ate Conflict of Interest Policy(06/04) P::e 2 of 3 ■=i■ DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 HOLCOMB & CABE, LLP A LIMITED LIABILITY PARTNERSHIP ATTORNEYS AT LAW 127 PMBERHILL PLACE BUILDING 100 CHAPEL HILL,NORTH CAROLINA 27514 TELEPHONE:(9191 928-5701 CAROL J.HOLCOMB TELEFAX(919)741-5817 SAMANTHA HYATT CABE WwW.HOLCOMBCABE.COM E-MAIL CJHOHOLCOMBCABE.COM July 7,2016 TO: ORANGE COUNTY DEPARTMENT OF SOCIAL SERVICES Carol J. Holcomb and Samantha H. Cabe, being duly sworn, say as follows: We certify that Holcomb& Cabe,LLP does not have any overdue tax debts, as defmed by N.C.G.S. 105-243.1, at the federal, State or local level. We further understand that any person who makes a false statement in violation of N.C.G.S. 143C-6-23(c) is guilty of a criminal offense punishable as provided by N.C.G.S. 143C-I 0-1(b). We are partners of Holcomb & Cabe, LLP, of Chapel Hill in the State of North Carolina; and that the foregoing certification is true, accurate and complete to the best of our knowledge and was made and subscribed by us. We also acknowledge and understand that any m' use of State funds will be reported to the appropriate authorities for further ac • kid Ari AO Carol J. (1.1 omb, Partner Samantha H. Cabe,Partner Sworn to and subscribed before me on the day of the date of said certification by Samantha H Cabe. chlo&tUrc, MARTHA H FORD Notary Signature and Seal NOTARY PUBLIC WAKE COUNTY,NC My Commission Expires: D.2.J2/.9/2 01 7 My CorrinIssion Expires 2-26-20.12 Sworn to and subscribed before me on the day of the date of said certification by Carol J. Holcomb 440 AwlktVt HA 6, taw atk" " No . ture and Seal A 4, --$70) 2-0 1- My Commission Expires: -P I &BO c, COUtv DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 ATTACHMENT C. CERTIFICATION REGARDING LOBBYING Orange County Department of Social Services Certification for Contracts, Grants, Loans and Cooperative Agreements The undersigned certifies,to the best of his or her knowledge and belief, that: (|) No Federal appropriated funds have been paid or will be paid by or on behalf of the undersigned,to any person for influencing or attempting to influence an officer or employee of any Federal, state or local government agency, a Member of Congress, a Member of the General Assembly, an officer or employee of Congress, an officer or employee of the General Assembly, an employee of a Member of Congress, or an employee of a Member of the General Assembly in connection with the awarding of any Federal or state contract, the making of any Federal or state grant, the making of any Federal or state loan,the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal or state contract, grant, loan, or cooperative agreement. (2) If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an of icer or employee of any Federal, state or local government agency, a Member of Congress, a Member of the General Assembly, an officer or employee of Congress, an officer or employee of the General Assembly, an employee of a Member of Congress, or ari employee of a Member of the General Assembly in connection with the awarding of any Federal or state contract, the making of any Federal or state grant, the making of any Federal or state loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal or state contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. (3) The undersigned shall require that the language of this certification be included in the award documents for all subawards at all tiers(including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall certify and disclose a000xdiog|y. (4) This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. Notwithstanding other provisions of federal OMB Circulars A-122 umd}\'87, costs associated with the following activities are unallowable: Paragraph A. (1) Attempts to influence the outcomes of any Federal, State, or local election, referendum, initiative, or similar procedure, through in kind or cash contributions, endorsements, publicity, or similar activity; '| (2) Establishing, administering, contributing to, or payi the expenses of a political party, campaign political action committee,or other organization established for the purpose of influencing the outcomes of elections; (3) Any attemp to influence: (i) The introduction of Federal or Stat legislation; or(ii)the enactment or modification of any pendi Federal or State legislation through communication with any member or employee of the Congress or State legislature(includi efforts to influence State or local Federal Certification—Lobbying(07/08) Page 1 of 3 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 officials to engage in similar lobbying activity), or with any Government official or employee in connection with a decision to sign or veto enrolled legislation; (4) Any attempt to influence: (i) The introduction of Federal or State legislation; or(ii)the enactment or modification of any pendi Federal or State legislation by preparing, distributing or using publicity or propaganda, or by u i members of the general public or any segment thereof to contribute to or participate in any mass demonstration, march, rally, fundraising drive, lobbying campaign or letter writing or telephone ; or (5) Legislative liaison activities, including attendance at legislative sessions or committee hearings, gathering information regarding legislation and analyzing the effect of legislation, when such activities are carried on in support of or in knowing preparation for an effort to engage in unallowable lobbying. The following activities as enumerated in Paragraph B are excepted from the coverag of Paragraph A: Paragraph ru�rup B. (1) Providing a technica and factua presentation of information on a topic directly related to the performance of a grant contract or other agreement through hearing testimony, statements or letter to the Congress or a State legislature, or subdivision, member, or cognizant staff member thereof, in response to a documented request(including a Congressional Record notice requesting testimony or statements for the record at a regularly scheduled hearing) made by the recipient member, legislative body or subdivision, or a cognizant staff member thereof; provided such information is readily obtainable and can be readily put in deliverable form; and further provided that costs under this section for travel, lodging or meals are unallowable unless incurred to offer testimony at a regularly scheduled Congressional hearing pursuant to a written request for such presentation made by the Chairman or Ranking Minority Member of the Committee or Subcommittee conducting such hearing. (2) Any lobbying made unallowable by subparagraph A(3)to influence State legislation in order to directly reduce the cost, orto avoid material impairment of the organization's authority to perform the grant, contract, or other agreement. (3) Any activity specifically authorized by statute to be undertaken with funds from the grant, contract, or other agreement. Paragraph C. (l) When an organization seeks reimbursement for indirect costs,total lobbying costs shall be separately identified in the indirect cost rate proposal, and thereafter treated as other unallowable activity costs in accordance with the procedures of subparagraph B.(3). (2) Organizations shall submit, as part of the annual indirect cost rate proposal, a certification that the requirements and standards of this paragraph have been complied with. (3) Organizations shall maintain adequate records to demonstrate that the determination of costs as being allowable or unallowable pursuant to this section complies with the requirements of this Circular. (4) Time logs, calendar , or similar records shall not be required to be created for purposes of complying with this paragraph during any particular calendar month w en: (l){bccmployee engages in lobbying(as defined in subparagraphs(a) and (b))25 percent or less of the employee's compensated hours of employment during that calendar month, and(2)within the preceding five- year period, the organization has not materially misstated allowable or unallowable costs of any nature, including legislative lobbying costs. When conditions(I)and (2)are met, organizations are not required to establish records to support the allowability of claimed costs in addition to records already required or maintained. Also, when conditions (1)and(2)are met, the absence of time logs, calendars, or similar records will not serve as a basis for disallowing costs by contesting estimates of lobbying time spent by employees during a calendar month. Federal Certification Lobbying(07/08) Page 2 of 3 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 (5) Agencies shall establish procedures for resolvi in advance, in consultation with 0MB, any significant questions or disagreements concerning the interpretation or application of this section. Any such advance resolution shall be binding in any subsequent settlements, audits or investigations with respect to that grant or contract for purposes of interpretation of this Circular; provided, however,that this shall not be construed to prevent a contractor or grantee from contesting the lawfulness of such a determination. Paragraph B. Executive lobbying costs. Costs incurred inuUnu attempting to improperly influence either directly or indirectly, an employee or officer of the Executive Branch of the Federal Government to give cnoaidemtiouoctoaot regarding a sponsored agreement or a regulatory matter are unallowable. Improper influence means any influence that induces or tends to induce a Federal employee or officer to give consideration or to act regarding a federally sponsored agreement or regulatory matter on any basis other than the merits of the matter. Fool,DocuSigned by: �^t ^ � L �~^"^ `."~°w^~ Attorney 370ra07^17C74c5. -_ — Signature Title Holcomb & cabe. LLP 7/I8/2015 -__ Agency/Organization Date (Certification s should he same as Contract sigliature.) Federal Certification-Lobbying(O7/08) Page 3 of 3 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 Contract 68-2001 Holcomb and Cabe, L.L.P ATTACHMENT H CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIQlDD.lTY ANDV0LDNIARYEXC[DS|ON-LOW2RTlBRCOVEBED TRANSACTIONS Orange County Department of Social Services Instructions for Certification I. By signing and submitting this proposal, the prospective lower tier participant is providing the certification set out below. 2. The certification in this clause is a material representation of the fact upon which reliance was placed when this transaction was entered into. If it is later deterniined that the prospective lower tier participant knowingly rendered an erroneous certification, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension and/or debarment. 3. The prospective lower tier participant will provide immediate written notice to the person to which the proposal is submitted if at any time the prospective lower tier participant learn that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 4. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "participant," "person," "primary covered transaction," "pcbucipaL" "proposal," and "voluntarily excluded," as used in this clause, have the meanings set out in the Definitions and Coverage sections of rules implementing Executive Order 12549. You may contact the person to which this proposal is submitted for assistance in obtaini a copy of those regulations. 5. The prospective lower tier participant agrees by submitti this proposal that, should the proposed covered transaction be entered into, it shall not knowingly enter any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation in this covered transaction unless authorized by the department or agency with which this transaction originated. 6. The prospective lower tier participant further agrees by submitting this proposal that it will include this clause titled "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion Lower Transaction," without modification, in all lower tier covered transactions and in all solicitations for lower tier covered transactions. 7. A participant in a covered transaction may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from covered transaction, unless it knows that the certification is erroneous. A participant may decide the method and frequency of which it determines the eligibility of its principals. Each participant may, but is not required to, check the Nonprocurement List. 8. Nothing contained in the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification required by this clause. The knowledge and information of a participant is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. Federal Certification Debarment(07/08) Page 1 of DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 Contract 68-200 l Holcomb and Cabe, LLP 9. Except for transactions authorized in paragraph 5 of these instructions, if a participant in a covered transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the Federal Government, the department or agency with which this transaction originated may pursue available remedies, including suspension, and/or debarment. Certification Regarding [)ebarment, Suspension, Ineligibility and Voluntary Exclusion - Lower Tier Covered Transactions (I) The prospective lower tier participant certifies, by submission of this proposal, that neither it nor its principals is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal department or agency, (2) Where the prospective lower tier participant is unable to certify to any of the statements in this certification, such prospective participant shall attach an explanation to this proposal. DocuSigned by: Coot Rotaiklii Attorney Sigo,ture7-A17-C74C--. Title Holcomb & cabe. LLP 7/I8/2010 Agency/Organization Date (Certification signature should be same as Contract signature.) Federal Certification- I)ebarment(07/08) Page 2 of 2 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 ATTACHMENT M STATE CERTIFICATION Contractor Certifications Re ' d by North Carolina Law Orange County Department of Social Services Instructions The person who signs this document should read the text of the statutes listed below and consult with counsel and other knowledgeable persons before signing. • The text of Article 2 of Chapter 64 of the North Carolina General Statutes can be found online at: bttp://vv"vv/.nc4o.s1at1.nc.uyDEouc1cdL u1u<ex/PDI7Byz1rticic/C rtiole 2.pd{ • The text of G.S, 105'164.8(b) can be found online at: http://wwvv.00gu.utmt nuo1&dLegim|otimn/5tut F/By5ecdou/Cboptcr 105 4.8.0f • The text o[G|8. l4]-48.5 (5.L. 20l]'4]8, o. 2.(d)) can bo found online at: http://,vvvv/.mcga.state.nc.us/Scuainns/20[3/8Ub/Uouye/PDF/H786*0.pdf • The text of G.S. 143-59.1 can be found online at: htto://,/v/v/.00gu.s%atc.nc.uo8EnuuhedLegi slat ion/Stadu1cx/PUF/Bv3eudoo/[hoptcr_|43/(}S_l4J-59.\.pdf • The text of G.S. 143-59.2 can be found online at: ,vp/.ncga.stniu.oc.os/EnuotedL_egis\q1ion/S\a\otce/PD /Cbuptccl43/GS 143'592.ndf • The text of G.S. 143C, Article 6A can be found online at: v/ou|eg`out/SuvsioIs/2015/B i 11 s/Segate/EfTML/5455!5JItDl Certifications (1) Pursuant to G.S. 143-48.5` the undersigned hereby certifies that the Contractor named below, and the Contractor's subcontractors, complies with the requirements of Article 2 of Chapter 64 of the NC General Statutes, including the requirement for each employer with more than 25 employees in North Carolina to verify the work authorization of its employees through the federal E-Verify oystemm." E-Verify System Link: WNV 1.1 So poY Local government is specifically exempt from Article 2 of Chapter 64 of the North Carolina General Statutes. However, local government is subject to and must comply with North Carolina General Statute §153/\-99.l., which states in part as follows: Counties Must Use E-Veril '. Each county shall register and participate in E-Verify to verify the work authoriation of new employees' hired to work in the United States. (2) Pursuant to G.S. 143-59.I(b), the undersigned hereby certifies that the Contractor named below is not an "ineligible Contractor"as set forth in G.S. 143-59.1(a) because: (a) Neither the Contractor nor any of its affiliates has refused to collect the use tax levied under Article 5 of Chapter 185 of the General Statutes on its sales delivered to North Carolina when the sales met one or more of the conditions of G.S. 105-164.8(b); and Contractor Certifications Required by North Carolina Law Rev. 6/16 Page 1 of2 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 (b) [check one of the following boxes] Neither the Contractor nor any of its affiliates has incorporated or reincorporated in a "tax have country" as set forth in G.8. l4]-54.1(6 (2)after December 3L2O0l; or [11 The Contractor or one of its affiliates has inc or reinc in a "tax haven country' as set forth in G.S. 143-50.1(o)(2) after December 31, 2001 but the United States is not th' priooipul market for the public trading of the stock of the corporation incorporated in the ta haven country. (3) Pursuant to G.S. 143-59.2(h), the undersigned hereby certifies that none of the Contractor's officers, director or owners (if the Contractor is an unincorporated business entity) has been convicted of any violation of Chaptbr 78A of the General Statutes or the Securities Act of 1933 or the Securities Exchange Act of 1934 within 10 year. immediately prior to the date of the bid solicitation. (4) The undersigned hereby certifies further that: (a) He or she is a duly authorized representative of the Contractor named below; (b) He or she is authorized to make, and does hereby make, the foregoing certifications on behalf of th Contractor; and ' (c) He or she understands that any person who knowingly submits a false certification in response to th requirements n[G.S. l435g.lmud 59.2 shall be guilty of a Class I felony. (5) Pursuant to G.S. 143C-6A-5, the undersigned hereby certifies that Contractor has not been identified, 000 has not utilized the services of any agent or subcontractor, on the list created by the State Treasurer pursua // to G.S. 147-88.58. DocuSigned by: Conti-(J6;4)0144614 7/18/2016 Signature of Contractor's Authorized Agent Date carol Holcomb Attorney o="u/•",d by. Print“ l��Q� �r»f�u�sAutborizod /\��uL Title .^,^vuuz� `` �o��� partner Sig,uu<urco noes Title Samantha H cabe 7/I0/2016 Printed Name of Witness Date The witness should be present when the Contractor's Authorized Agent signs this certification and should sign and dal- this document immediately thereafter. Contractor Certifications Required by North Carolina Law Rev. 6/16 Page 2 of DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 ATTACHMENT N 1 OUTCOMES AND REPORT[NG Orange County Department of Social Services By signing and submitti this document, the Contractor certifies that it agrees to the following: 1. The Contractor agrees to participate participate in proam, fiscal and administrative monitoring and/or audits, making records and staff time available to Federal, Stat and County staff. 2. The Contractor agrees to take necessary steps for corrective action, as negotiated within a corrective action plan, for any items found to be out of compliance with Federal, State, and County laws,regulations, standards and/or terms of the Contract. 3. The Contractor agrees that continuation of and/or renewal of this Contract is contingent on meeting the following requirements. The Contractor agrees to: A. Assure that all court proceedings be conducted within the timeframes required by General Statute. B. Provide case consultation to Orange County Department of Social Services staff within a reasonable timeframe so as to assure client safety and compliance with North Carolina laws and regulations. C. Assure tha all court orders are prepared in a timely manner. c o°".om"°«^v' Coot Attorney �e���3 - Signature Title Holcomb & cabe. LLP 7/I8/2016 Agency/Organization Date / (Certification signature should be same as Contract signature.) / / | Outcomes (06/04) Page 1 of 1 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 LAWYERSLIABILITY INSURANCE 5020 Weston Parkway, Suite 2(8) 919.677.8900 III COMPANY OF Cary, North Carolina 2751 i 800.662.8841 toi FRU :\/1 LTTUAL _ NORTH CAROLINA Post Office,Box 1929 919.677.9641 AX Cary, North Carolina 27S12-1')2 ) www.lawyerstnutualnc.com Declarations HOLCOMB & CABE LLP 100 TIMBERHILL PLACE, STE 127 CHAPEL HILL, NC 27514 Policy Number: 31629-4 Policy Period: 07/01/2016 to 07/01/2017 12:01 A.M.Standard Time at the address of the Named Insured stated herein Prior Acts Date of Named Insured: 07/01/2013 Limits of Liability: A. $ 1,000,000 A. Applicable to any claim or one or more related claims. B. $ 1,000,000 B. Aggregate limit of the Company's liability for all damages and claims expenses without regard to the number of Insureds, Extended Reporting Endorsements, claims, suits, or claimants. Deductible: C. $ 5,000 C. See INSURING AGREEMENT VI. Deductible and (including claims expenses) Limit of Liability. Premium: $ 4,026 Endorsement Attachments: 012 In witness whereof,Lawyers Mutual Liability Insurance Company of North Carolina has caused this Policy to be signed by its President and Secretary and countersigned by a duly authorized agent of the Company. 4 , i )- 411, Secretary M . (e;;;;-66* D/AMille-P Ve Pre ident Authorized Agent Lawyers Professional Liability Policy (This is a Claims-Made and Reported Policy. Defense costs are a part of the Policy Limits and reduce the amount available to pay losses. You should read your Policy for a complete understanding of its Terms, Conditions&Coverages). (08/01/2015.2) PolicyFor m 31629 - 2016 1 1 DocuSign Envelope ID:8F6AD7AB-CE9D-40C4-B5FA-6FCBA99F62F3 LA FRS LIABILITY INSURANCE "i020 VVeston Parkway, Suite 200 910.677.8900 t Cary, North Carana 2751 i 800.662.8843 TO k0 4 COM PA N Y OF 919.677.9641 tAX MUTUAL NORTH CAROLINA Post Office Box 1929 (ary, North Carolma 27512-1929 www.lawyersmuttiainccom Insured Listing / Prior Acts. Date Endorsement This Endorsement, effective 12:01 A.M. on 07/01/2016 forms a part of Policy No. 31629-4 (the "Policy") issued by LAWYERS MUTUAL LIABILITY INSURANCE COMPANY OF NORTH CAROLINA and applies to HOLCOMB&CABE LIP(the "Named Insured"). It is hereby understood and agreed that as to each Insured listed below, this Policy shall not apply to such Insured's act(s) or omission(s), or series of related act(s) or omission(s), occuring or beginning prior to the date listed individually for each Insured below("Prior Acts Date"). All Policy provisions, terms, exclusions, and conditions, except as provided otherwise in this Endorsement, remain in full force and effect. Name Licensing State License Prior Acts Date (or Other), Number 1. SAMANTHA HYA I I CABE NC 28461 09/03/2002 2. CAROL JAN HOLCOMB NC 16357 04/30/1989 Authorized Agent END#: 012 (0a/01/2015) Page 1 of 1 AttyLiStPALE 31629 2016